There seem to be seasons for cancer conversations.

In the summer, we talk about staying hydrated, protecting sensitive skin from the sun, and managing treatment in the heat. October brings awareness campaigns, education, pink ribbons, and fundraising events. There are seasons when certain topics naturally rise to the surface.

But there are other realities of cancer that rarely get discussed.

I sometimes think of them as the shadows of cancer—not because they should remain hidden, but because they often do. They are the difficult conversations that make people uncomfortable. Yet they are the very conversations that need light.

Having spent many years in the cancer community, I’ve seen things that are rarely mentioned in brochures, awareness campaigns, or fundraising appeals.

I’ve spoken with mothers who discovered that their children had been taking their pain medications. What began as medication prescribed for legitimate cancer pain became something else entirely. One day they noticed pills missing, bottles emptying too quickly, and suddenly they found themselves facing a crisis they never imagined—an addiction problem in their own home.

How do you even begin to talk about that?

How do you process the guilt, fear, and self-blame that follow?

These mothers love their children. The medications were there because the mothers were suffering. No one intended for harm to happen. Yet it happened anyway. And because we rarely discuss these situations openly, many families feel completely alone when they face them.

Then there is another reality that breaks my heart every time I encounter it.

More than once, I have received a phone call from someone in the final stages of cancer who quietly revealed that they were being abused by the person who was supposed to care for them.

One woman called me from her hospital room. She was dying. Through tears, she told me that her husband had arrived drunk the night before, physically assaulted her, and told her she wasn’t dying fast enough.

The staff had not witnessed what happened. She called me the next morning bruised, frightened, and ashamed.

As we talked, she revealed something even more heartbreaking: this wasn’t new. He had abused her throughout their marriage. She had simply never told anyone.

I want to be careful here. These situations do not arise because cancer somehow causes good people to suddenly become abusive. In the cases I have encountered, the abuse was already present. Cancer didn’t create it—it exposed it.

The same can be true of other struggles. Cancer doesn’t always reveal humanity at its best. Sometimes it exposes fractures that were already there. Sometimes it magnifies problems that had been quietly growing beneath the surface. And sometimes the enormous stress of serious illness brings existing weaknesses into plain view.

These realities are painful to discuss. They are uncomfortable. They don’t fit neatly into awareness campaigns or inspirational stories.

But silence does not protect people.

If anything, silence leaves people isolated when they most need support.

We have to be willing to talk about the collateral damage that can accompany cancer—the struggles that reach far beyond the disease itself. Only by acknowledging these realities can we begin to find solutions, offer support, and protect those who are vulnerable.

So if you are in trouble, tell someone.

If you are being harmed, tell someone.

If you are carrying a burden that feels too heavy to share, tell someone.

There is help available. There are people who will listen. And there is no shame in asking for help.

Some of the hardest stories in the cancer world live in the shadows. It is time we bring them into the light.